Kawasaki Disease in Children

Kawasaki disease is a rare condition that causes swelling and inflammation of the walls of the blood vessels (vasculitis). This condition commonly affects the blood vessels of the heart.

It also affects the skin as well as the mucous membranes and lymph nodes. It is important to treat Kawasaki disease as soon as possible to help prevent any long-term effects.

What are the causes?

The cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in:

• Children who are younger than 5 years old.
• Children of Asian or Pacific Island descent.
• Boys.

What are the signs or symptoms?

Symptoms of this condition occur in three phases. Fever lasting for five or more days is the most consistent symptom.

Symptoms in the first phase include:

• Very red eyes.
• High fever over 102.2°F (39°C).
• Irritability.
• Red, cracked, or chapped lips.
• Red, swollen tongue (strawberry tongue).
• Skin rash on the body and in the genital area.
• Red, swollen hands and feet.
• Swollen lymph nodes, usually in the neck.

Second phase symptoms include:

• Peeling of the skin on the palms of the hands or the soles of the feet.
• Swollen, painful joints.
• Nausea.
• Vomiting.
• Diarrhea.
• Pain in the abdomen.

During the third phase, symptoms slowly decrease. This may take up to 8 weeks. However, complications from the disease can develop if symptoms are not treated within the first ten days.

How is this diagnosed?

This condition is diagnosed based on a physical exam and your child’s symptoms. Other tests may be done, including:

• Blood tests.
• X-rays.
• Urine tests.
• Electrocardiogram (ECG).
• Echocardiogram.

How is this treated?

Treatment usually occurs in the hospital and may include:

• Infusion of an immune protein (immunoglobulin) called IVIG. This is given through an IV. The medicine decreases the risk of damage to the heart.
• Aspirin. This helps with fever, pain, and rash. It also helps to prevent blood clots. Your child may need to take aspirin for 6 weeks or longer.
• Medicines to prevent blood clots.

Though rare, heart damage can occur as a complication of this condition. If this happens, treatment may include monitoring your child for heart problems and, if needed, performing heart surgery to correct the problem.

Follow these instructions at home:

• Give over-the-counter and prescription medicines only as told by your child’s health care provider.
• Make sure your child is up-to-date on his or her immunizations. However, some immunizations may need to be delayed if your child is receiving IVIG treatment. Follow instructions from your child’s health care provider about your child’s immunization schedule.
• Do not give aspirin to your child unless you are instructed to do so by your child’s health care provider. If your child’s health care provider has approved the use of aspirin, stop giving it to your child if he or she develops any new symptoms that may indicate that he or she has influenza or chicken pox. These symptoms may include:
  • Fever.
  • Headache.
  • Poor appetite.
  • An itchy rash that changes over time from red spots, to bumps, to fluid-filled blisters.
  • Chills.
  • Body aches.
  • Sore throat.
  • Cough.
  • Runny or congested nose.
  • Weakness or fatigue.
  • Dizziness.
  • Nausea or vomiting.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

• Your child has a fever.
• Your child has new symptoms.
• Your child’s symptoms get worse.
• Your child was prescribed aspirin and develops symptoms of influenza or chickenpox.

Get help right away if:

• Your child has shortness of breath.
• Your child’s legs are swollen.
• Your child is unable to lie flat in bed.
• Your child has chest pain.
• Your child who is younger than 3 months old has a temperature of 100°F (38°C) or higher.

Summary

• Kawasaki disease is a rare condition that causes swelling and inflammation of the walls of the blood vessels (vasculitis). This condition commonly affects the blood vessels of the heart. This condition also affects the mucous membranes, lymph nodes, and skin.
• Fever lasting for five or more days is the most consistent symptom. Complications from the disease can develop if symptoms are not treated within the first ten days of symptoms. Treatment usually occurs in the hospital.
• Contact your health care provider right away if your child was prescribed aspirin and develops symptoms of influenza or chickenpox.